Thyroglobulin quantitation by mass spectrometry

ABSTRACT

Provided are methods for determining the amount of thyroglobulin in a sample using various purification steps followed by mass spectrometry. The methods generally involve purifying thyroglobulin in a test sample, digesting thyroglobulin to form peptide T129, purifying peptide T129, ionizing peptide T129, detecting the amount of peptide T129 ion generated, and relating the amount of peptide T129 ion to the amount of thyroglobulin originally present in the sample.

CROSS REFERENCE TO RELATED PATENT APPLICATIONS

This application is a Continuation of U.S. application Ser. No.14/053,423, filed Oct. 14, 2103, which is a Continuation of U.S.application Ser. No. 13/859,551, filed Apr. 9, 2013, now U.S. Pat. No.8,574,915, which is a Continuation of U.S. application Ser. No.13/198,620, filed Aug. 4, 2011, now U.S. Pat. No. 8,455,259, which is aContinuation of U.S. application Ser. No. 12/001,076, filed Dec. 6,2007, now U.S. Pat. No. 8,030,084, the entire contents of each of whichare incorporated by reference herein.

SEQUENCE LISTING

The instant application contains a Sequence Listing which has beensubmitted in ASCII format via EFS-Web and is hereby incorporated byreference in its entirety. Said ASCII copy, created on Sep. 15, 2011, isnamed 54769284.txt and is 62,398 bytes in size.

FIELD OF THE INVENTION

The invention relates to the quantitation of thyroglobulin. In aparticular aspect, the invention relates to methods for quantitation ofthyroglobulin by mass spectrometry.

BACKGROUND OF THE INVENTION

The following description of the background of the invention is providedsimply as an aid in understanding the invention and is not admitted todescribe or constitute prior art to the invention.

Thyroglobulin, or Tg, is a large dimeric secretary glycoprotein with amolecular weight of 660 kDa comprised of noncovalently bound homodimers.

Tg molecules exist in several forms. The three major Tg moleculesequences as found in the UniProt Knowledgebase (Swiss-Prot+TrEMBL) areP01266 (Human Thyroglobulin Precursor), P01266-2 (Isoform 2 of P01266),and Q59GF02 (Human Thyroglobulin Variant). (See FIGS. 1, 2, and 3,respectively.)

P01266 is the major variant of P01266 with a length of 2768 AA; P01266-2is an isoform of P01266 with a length of 2711 AA. P01266-2 varies fromP01266 at amino acid positions 1510 to 1567 of Tg; and Q59GF0 is athyroglobulin fragment with a length of 1574 AA. Q59GF0 contains aminoacids from positions 1212 to 2768 of Tg.

Tg can only be produced in the thyroid gland and may be produced byeither normal well differentiated benign thyroid cells or thyroid cancercells. It is the precursor protein for thyroid hormone syntheses andserves as the matrix for thyroid iodine storage. Tg is used by thethyroid gland to produce the thyroid hormones thyroxine (T4) andtriiodothyroine (T3). Tg levels in the blood can be used as a tumormarker for differentiated thyroid carcinoma (DTC). A high level of Tg inthe blood is not by itself an indicator of thyroid cancer, butpersistence of Tg in the blood following surgical removal of the thyroidgland indicates persistence of thyroid tissue. A course of treatmentfollowing detection of Tg in the blood following surgical removal of thethyroid gland may include administration of radioiodine to ablate allremaining normal thyroid. Continued persistence of Tg in the bloodfollowing ablation of all normal thyroid could indicate that some amountof tumor is still present.

Several methods for quantaition of Tg have been developed. For exampleSpencer, et al., Thyroid, 1999, 9(5):435-41 and Persoon, et al.,Clinical Chem 2006, 52(4):686-691 disclose immunometric,radioimmunometric, and immunochemiluminometric methods for quantitationof Tg. These methods are all subject to methodological problems such asdifferences in standardization, variability in interassay sensitivityand precision, hook effects, and interference attributable to Tgantibodies. The problem of interference attributable to Tg antibodies isparticularly troubling for clinical application of monitoring Tg levelsas a tumor marker because up to 20% of thyroid cancer patients have Tgautoantibodies.

SUMMARY OF THE INVENTION

The present invention provides methods for quantitation of Tg in asample by mass spectrometry, including tandem mass spectrometry.

In one aspect, methods are provided for determining the amount of Tg ina test sample that include: (a) subjecting a Tg containing test sampleto digestion resulting in creation of Tg peptides; (b) purifying one ormore Tg peptides; (c) ionizing one or more Tg peptides; (d) detectingthe amount of the Tg peptide ion(s) by mass spectrometry; and (e)relating the amount of detected Tg peptide ion(s) to the amount of Tg inthe test sample. A preferred enzyme for preparing Tg peptides istrypsin. A suitable Tg peptide for the method is one that can beevaluated by mass spectrometry and can be sufficiently purified fromrelated peptides that may be generated from proteins other than Tg. Anexample of one such peptide is peptide T129 (sequence VIFDANAPVAVR) (SEQID NO: 4) which contains amino acids from positions 1579 to 1590 of Tg,has a molecular weight of about 1,270 Da, and is present in all threeisoforms of Tg. See FIG. 4.

Formation of peptide T129 provides a unique trypsin generated peptidefor thyroglobulin. Also, creation of peptide T129 from tryptic digestionof Tg should be unaffected by the presence or absence of the Tgantibodies. Thus, measurement of the increase in peptide T129 in a testsample offers a way of quantitating the amount of Tg originally in thetest sample free from inference from Tg antibodies.

Any appropriate method may be used to determine the amount of Tg peptideresulting from digestion of Tg in a sample. In the event that a testsample may contain endogenous Tg peptide, steps may be taken to makecertain that the endogenous peptide is not confused with peptidegenerated by digesting Tg in sample. One approach is to remove theendogenous Tg peptide from the sample before digesting Tg. This maydone, for example, using a size separation technique. Another approachis to analyze a portion of a test sample according to the claimedmethods but excluding the digestion step in order to establish abaseline level for the endogenous peptide in the test sample. In thisapproach, the once a baseline is determined, it can be subtracted fromthe post-digestion level of the peptide, the later representing both theendogenous peptide and that generated by digestion.

Because the methods may be applied to complex test samples (particularlybody fluids or test samples derived from tissue), steps may be taken topurify Tg in the test sample prior to digestion. This may done, forexample, using a size separation technique.

In some embodiments, the methods include generating one or more Tgpeptide ions in which at least one of the ions has a mass/charge ratio(m/z) corresponding to that of (singly or multiply charged) peptide T129ions. In preferred related embodiments, the methods include generatingone or more Tg peptide ions in which at least one has m/z of 1272.8±0.5,636.4±0.5, or 424.3±0.5 (corresponding to singly, doubly, or triplycharged peptide T129 ions). In related preferred embodiments, themethods may include generating one or more fragment ions of a Tg peptideion in which at least one has a m/z of 541.3±0.5, 612.3±0.5, 726.4±0.5,797.4±0.5, 912.4±0.5, or 1059.5±0.5; preferably one or more of thefragment ions are selected from the group consisting of ions with a m/zof 797.4±0.5, 912.4±0.5, and 1059.5±0.5.

In some embodiments, the purification in step (b) is accomplished withat least one size separation technique. Preferably, size separationtechniques may be filtration, LC, or any combination thereof. In certainpreferred embodiments, the test sample is a body fluid or tissue. Insome embodiments, an additional step is included where a second quantityof the test sample is subjected to steps (b) through (e) in order toestablish a baseline level of one or more endogenous Tg peptides. Inthese embodiments, this baseline level can be subtracted from the amountof Tg peptide ion(s) detected in the test sample to determine the amountof Tg peptide ion(s) that result from Tg in the original test sample. Inother embodiments, the methods include an additional initial step ofpurifying Tg in the test sample prior to digestion. In theseembodiments, the pre-digestion purification and/or the purification instep (b) may each be accomplished with at least one size separationtechnique. Preferably, at least one size separation technique used inboth pre-digestion purification and step (b) is filtration; morepreferably, this filtration is done with a molecular weight cut-offfilter with molecular weigh cut off that allows for retention of Tgabove the filter and allows Tg peptides to pass through with thefiltrate. In related embodiments, the molecular weigh cut-off is about 2kD to 300 kD; more preferably about 100 kD to 300 kD. In theseembodiments, the two filtrations (pre-digestion and step (b)) may beconducted with the same filter.

In a second aspect, methods are provided for determining the amount ofTg in a test sample that include: (a) subjecting a Tg containing testsample to digestion resulting in creation of peptide T129; (b) purifyingpeptide T129; (c) ionizing peptide T129 to generate a precursor ion witha m/z of 636.4±0.5; (d) fragmenting the peptide T129 precursor ion toform one or more fragment ions in which at least one has a m/z of about797.4±0.5, 912.4±0.5, or 1059.5±0.5; detecting the amount of peptideT129 precursor ions, one or more fragment ions, or both, by massspectrometry; and (e) relating the amount of detected ion(s) to theamount of Tg in the test sample. In certain preferred embodiments, thetest sample is a body fluid or tissue or tissue. In some embodiments, anadditional step is included where a second quantity of the test sampleis subjected to steps (b) through (e) in order to establish a baselinelevel of one or more endogenous peptide T129. In these embodiments, thisbaseline level can be subtracted from the amount of peptide T129 ion(s)detected in the test sample to determine the amount of peptide T129ion(s) that result from Tg in the original test sample. In otherembodiments, the methods include an additional initial step of purifyingTg in the test sample prior to digestion. In these embodiments, thepre-digestion purification and/or the purification in step (b) may eachbe accomplished with at least one size separation technique. Preferably,at least one size separation technique used in both pre-digestionpurification and step (b) is filtration; more preferably, thisfiltration is done with a molecular weight cut-off filter with molecularweigh cut off that allows for retention of Tg above the filter andallows Tg peptides to pass through with the filtrate. In relatedembodiments, the molecular weigh cut-off is about 2 kD to 300 kD; morepreferably about 100 kD to 300 kD. In these embodiments, the twofiltrations (pre-digestion and step (b)) may be conducted with the samefilter.

As used herein, the term “purification” or “purifying” does not refer toremoving all materials from the sample other than the analyte(s) ofinterest. Instead, purification refers to a procedure that enriches theamount of one or more analytes of interest relative to one or more othercomponents of the sample. Purification, as used herein, does not requirethe isolation of an analyte from all others. In preferred embodiments, apurification step or procedure can be used to remove one or moreinterfering substances, e.g., one or more substances that wouldinterfere with the operation of the instruments used in the methods orsubstances that may interfere with the detection of an analyte ion bymass spectrometry.

As used herein, the term “about” in reference to quantitativemeasurements, not including the measurement of mass of an ion, refers tothe indicated value plus or minus 10%.

As used herein, the term “substantially all” refers to any proportiongreater than 50%, more preferably greater than 60%, more preferablygreater than 70%, more preferably greater than 80%, and more preferablygreater than 90%.

As used herein, the term “test sample” refers to any sample that maycontain Tg. As used herein, the term “body fluid or tissue” means anyfluid or tissue that can be isolated from the body of an individual. Forexample, “body fluid or tissue” may include blood, plasma, serum, bile,saliva, urine, tears, perspiration, and the like. If solid tissue is tobe analyzed, it may be processed to release a liquid fraction that couldcontain any Tg present in the tissue. The liquid fraction can then besubject to the methods described herein.

As used herein, the term “digestion” means proteolytic cleavage ofproteins into peptides. Digestion agents may include trypsin, Lyc-C,Arg-R, Asp-N and the like. Digestion is carried out by adding adigestion agent (i.e., an enzyme) to a sample and incubating for someperiod of time.

As used herein, “Tg” or “Tg molecule” means an intact Tg proteinmolecule.

As used herein, the term “Tg peptide” means any peptide of 100 aminoacids or less that is a fragment of the native Tg. Tg peptides can beendogenous to a test sample or formed as a result of digestion of Tg.Peptide T129 is an example of a Tg peptide formed as a result of trypsindigestion of Tg.

As used herein, the term “size separation technique” means any technique(physical or chemical) that allows for the separation of at least onespecies from a test sample based on any one or more of molecular weightand shape. Examples of such techniques include, but are not limited to,filtration, chromatography, and certain aspects of mass spectrometry.

As used herein, the term “chromatography” refers to a process in which achemical mixture carried by a liquid or gas is separated into componentsas a result of differential distribution of the chemical entities asthey flow around, over, and/or through a stationary liquid or solidphase.

As used herein, the term “liquid chromatography” or “LC” means a processof selective retardation of one or more components of a fluid solutionas the fluid uniformly percolates through a column of a finely dividedsubstance, or through capillary passageways. The retardation resultsfrom the distribution of the components of the mixture between one ormore stationary phases and the bulk fluid, (i.e., mobile phase), as thisfluid moves relative to the stationary phase(s). “Liquid chromatography”includes reverse phase liquid chromatography (RPLC), high performanceliquid chromatography (HPLC) and high turbulence liquid chromatography(HTLC).

As used herein, the term “high performance liquid chromatography” or“HPLC” refers to liquid chromatography in which the degree of separationis increased by forcing the mobile phase under pressure through astationary phase, typically a densely packed column.

As used herein, the term “mass spectrometry” or “MS” refers to ananalytical technique to identify compounds by their mass. MS refers tomethods of filtering, detecting, and measuring ions based on their m/z.MS technology generally includes (1) ionizing the compounds to formcharged species (e.g., ions); and (2) detecting the molecular weight ofthe ions and calculating their m/z. The compounds may be ionized anddetected by any suitable means. A “mass spectrometer” generally includesan ionizer and an ion detector. In general, one or more molecules ofinterest are ionized, and the ions are subsequently introduced into amass spectrographic instrument where, due to a combination of magneticand electric fields, the ions follow a path in space that is dependentupon mass (“m”) and charge (“z”). See, e.g., U.S. Pat. No. 6,204,500,entitled “Mass Spectrometry From Surfaces;” U.S. Pat. No. 6,107,623,entitled “Methods and Apparatus for Tandem Mass Spectrometry;” U.S. Pat.No. 6,268,144, entitled “DNA Diagnostics Based On Mass Spectrometry;”U.S. Pat. No. 6,124,137, entitled “Surface-Enhanced PhotolabileAttachment And Release For Desorption And Detection Of Analytes;” Wrightet al., Prostate Cancer and Prostatic Diseases 2:264-76 (1999); andMerchant and Weinberger, Electrophoresis 21:1164-67 (2000).

As used herein, the term “operating in positive ion mode” refers tothose mass spectrometry methods where positive ions are detected.Similarly, the term “operating in negative ion mode” refers to thosemass spectrometry methods where negative ions are detected.

As used herein, the term “ionization” or “ionizing” refers to theprocess of generating an analyte ion having a net electrical chargeequal to one or more electron units. Positive ions are those having anet positive charge of one or more electron units. Negative ions arethose having a net negative charge of one or more electron units.

As used herein, the term “electron ionization” or “EI” refers to methodsin which an analyte of interest in a gaseous or vapor phase interactswith a flow of electrons. Impact of the electrons with the analyteproduces analyte ions, which may then be subjected to a massspectrometry technique.

As used herein, the term “chemical ionization” or “CI” refers to methodsin which a reagent gas (e.g. ammonia) is subjected to electron impact,and analyte ions are formed by the interaction of reagent gas ions andanalyte molecules.

As used herein, the term “fast atom bombardment” or “FAB” refers tomethods in which a beam of high energy atoms (often Xe or Ar) impacts anon-volatile sample, desorbing and ionizing molecules contained in thesample. Test samples are dissolved in a viscous liquid matrix such asglycerol, thioglycerol, m-nitrobenzyl alcohol, 18-crown-6 crown ether,2-nitrophenyloctyl ether, sulfolane, diethanolamine, andtriethanolamine. The choice of an appropriate matrix for a compound orsample is an empirical process.

As used herein, the term “matrix-assisted laser desorption ionization”or “MALDI” refers to methods in which a non-volatile sample is exposedto laser irradiation, which desorbs and ionizes analytes in the sampleby various ionization pathways, including photoionization, protonation,deprotonation, and cluster decay. For MALDI, the sample is mixed with anenergy-absorbing matrix, which facilitates desorption of analytemolecules.

As used herein, the term “surface enhanced laser desorption ionization”or “SELDI” refers to another method in which a non-volatile sample isexposed to laser irradiation, which desorbs and ionizes analytes in thesample by various ionization pathways, including photoionization,protonation, deprotonation, and cluster decay. For SELDI, the sample istypically bound to a surface that preferentially retains one or moreanalytes of interest. As in MALDI, this process may also employ anenergy-absorbing material to facilitate ionization.

As used herein, the term “electrospray ionization” or “ESI,” refers tomethods in which a solution is passed along a short length of capillarytube, to the end of which is applied a high positive or negativeelectric potential. Solution reaching the end of the tube is vaporized(nebulized) into a jet or spray of very small droplets of solution insolvent vapor. This mist of droplets flows through an evaporationchamber, which is heated slightly to prevent condensation and toevaporate solvent. As the droplets get smaller the electrical surfacecharge density increases until such time that the natural repulsionbetween like charges causes ions as well as neutral molecules to bereleased.

As used herein, the term “atmospheric pressure chemical ionization” or“APCI,” refers to mass spectrometry methods that are similar to ESI;however, APCI produces ions by ion-molecule reactions that occur withina plasma at atmospheric pressure. The plasma is maintained by anelectric discharge between the spray capillary and a counter electrode.Then ions are typically extracted into the mass analyzer by use of a setof differentially pumped skimmer stages. A counterflow of dry andpreheated N₂ gas may be used to improve removal of solvent. Thegas-phase ionization in APCI can be more effective than ESI foranalyzing less-polar species.

The term “Atmospheric Pressure Photoionization” or “APPI” as used hereinrefers to the form of mass spectrometry where the mechanism for thephotoionization of molecule M is photon absorption and electron ejectionto form the molecular M+. Because the photon energy typically is justabove the ionization potential, the molecular ion is less susceptible todissociation. In many cases it may be possible to analyze sampleswithout the need for chromatography, thus saving significant time andexpense. In the presence of water vapor or protic solvents, themolecular ion can extract H to form MH+. This tends to occur if M has ahigh proton affinity. This does not affect quantitation accuracy becausethe sum of M+ and MH+ is constant. Drug compounds in protic solvents areusually observed as MH+, whereas nonpolar compounds such as naphthaleneor testosterone usually form M+. Robb, D. B., Covey, T. R. and Bruins,A. P. (2000): See, e.g., Robb et al., Atmospheric pressurephotoionization: An ionization method for liquid chromatography-massspectrometry. Anal. Chem. 72(15): 3653-3659.

As used herein, the term “inductively coupled plasma” or “ICP” refers tomethods in which a sample is interacted with a partially ionized gas ata sufficiently high temperature to atomize and ionize most elements

As used, herein, the term “field desorption” refers to methods in whicha non-volatile test sample is placed on an ionization surface, and anintense electric field is used to generate analyte ions.

As used herein, the term “desorption” refers to the removal of ananalyte from a surface and/or the entry of an analyte into a gaseousphase.

As used herein, the term “limit of quantification” or “LOQ” refers tothe point where measurements become quantitatively meaningful. Theanalyte response at this LOQ is identifiable, discrete and reproduciblewith a precision of 20% and an accuracy of 80% to 120%.

In certain preferred embodiments of the methods disclosed herein, massspectrometry is performed in positive ion mode. In certain particularlypreferred embodiments of the methods disclosed herein, mass spectrometryis performed using ESI as the method of creating ions from Tg peptides.

In preferred embodiments, the ions from Tg peptide ionization detectablein a mass spectrometer are selected from the group consisting of ionswith a m/z of 636.4±0.5, 1059.5±0.5, 921.4±0.5, 797.4±0.5, 726.4±0.5,612.3±0.5, and 541.3±0.5; the first ion listed (m/z of 636.4±0.5) beinga precursor ion with a net charge of positive 2 electron units and thelatter six ions listed being fragment ions of the precursor ion. Inparticularly preferred embodiments, the precursor ion has a net chargeof positive 2 electron units and a m/z of about 636.4±0.5, and thefragment ions have a m/z of 1059.5±0.5, 921.4±0.5, or 797.4±0.5.

In some preferred embodiments, a separately detectable internal standardpeptide (e.g., T129) is introduced in the test sample after trypsindigestion. In these embodiments, all or a portion of the peptide presentin the test sample both from digestion of endogenous Tg and the additionof the internal standard are ionized to produce a plurality of ionsdetectable in a mass spectrometer, and one or more ions produced fromthe peptide ionization are detected in a mass spectrometer.

In other preferred embodiments, a separately detectable internal Tgstandard is provided in the test sample prior to trypsin digestion. Inthese embodiments, all or a portion of both the endogenous Tg and theinternal standard present in the test sample are digested by trypsinresulting in formation of Tg peptides. Tg peptides are ionized toproduce a plurality of ions detectable in a mass spectrometer, and oneor more ions produced from Tg peptide ionization are detected by massspectrometry.

In preferred embodiments, the ions detectable in a mass spectrometerproduced from the ionization of Tg peptides resulting from Tg digestionare selected from the group consisting of ions with a m/z of 636.4±0.5,1059.5±0.5, 921.4±0.5, 797.4±0.5, 726.4±0.5, 612.3±0.5, and 541.3±0.5;the first ion listed (m/z of 636.4±0.5) being a precursor ion with a netcharge of positive 2 electron units and the latter six ions listed beingfragment ions of the precursor ion. In particularly preferredembodiments, the precursor ion has a net charge of positive 2 electronunits and a m/z of 636.4±0.5, and the fragment ions have a m/z of1059.5±0.5, 921.4±0.5, 797.4±0.5.

In preferred embodiments, the presence or amount of Tg peptide ions isrelated to the presence or amount of Tg in the original test sample bycomparison to a reference Tg sample.

In one embodiment, the methods involve the combination of LC with massspectrometry. In another preferred embodiment, the mass spectrometry istandem mass spectrometry (MS/MS).

The summary of the invention described above is non-limiting and otherfeatures and advantages of the invention will be apparent from thefollowing detailed description of the invention, and from the claims.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows the amino acid sequence for P01266 (Human ThyroglobulinPrecursor) (SEQ ID NO: 1).

FIG. 2 shows the amino acid sequence for P01266-2 (Isoform 2 of P01266)(SEQ ID NO: 2).

FIG. 3 shows the amino acid sequence for Q59GF0 (ThyroglobulinVariant-Fragment) (SEQ ID NO: 3).

FIGS. 4A through 4G show a comparison of the three sequences containedin FIGS. 1-3 demonstrating that they all contain amino acidscorresponding to positions 1579 to 1590 of Tg. Sequence P01266 is on top(SEQ ID NO: 1); sequence P01266-2 is in the middle (SEQ ID NO: 2); andsequence Q59GF0 is at the bottom (SEQ ID NO: 3).

FIG. 5 shows the limit of quantitation verification for Tg peptide ionwith m/z corresponding to peptide T129 by MS/MS. The equation describingthe trend line for FIG. 5 is as follows:y=1E-05x⁴−0.0007x³+0.0114x²−0.0787x+0.2606. R²=0.9833 for this fit.Details are described in Example 1.

FIG. 6 shows the linearity of the quantitation of peptide T129 inserially diluted stock samples using an LC-MS/MS assay. The equationdescribing the trend line for FIG. 6 is as follows:y=26.919x²+2939.4x+310.78. R²=0.9988 for this fit. Details are describedin Example 1.

FIG. 7 shows the limit of quantitation verification for peptide T129 instripped serum by MS/MS. The equation describing the trend line for FIG.7 is as follows: y=1807.2x−1975. R²=0.9993 for this fit. Details aredescribed in Example 2.

FIG. 8 shows the linearity of the quantitation of peptide T129 inpeptide T129 spiked stripped serum using an LC-MS/MS assay. Details aredescribed in Example 2.

FIG. 9 shows the linearity of the quantitation of Tg peptide ions withm/z corresponding to peptide T129 using an LC-MS/MS assay in strippedserum spiked with Tg prior to processing and concentration according tothe methods described herein. The equation describing the trend line forFIG. 9 is as follows: y=218.15x+8363.2. R²=0.9681 for this fit. Detailsare described in Example 3.

DETAILED DESCRIPTION OF THE INVENTION

Methods are described for quantitatively measuring Tg in a test sample.This quantitative measurement is achieved through the use of LC-MS/MStechniques. Prior to the use of LC-MS/MS, samples may be prepared by thefollowing technique, or any portion thereof. A first purification of Tgin a test sample may be conducted through the use of a size separationtechnique such that substantially all Tg in the test sample is retained.Following the first purification step, enzymatic digestion of Tg may becarried out creating Tg peptides of interest. After digestion, anotherutilization of a size separation technique may be employed such that aselected Tg peptide generated in the enzymatic digestion of Tg ispurified. This second size separation technique can be used to removesubstantially all undigested, higher-molecular weight species. Properlyexecuted, the sample preparation techniques ensure that selected Tgpeptides quantitated by LC-MS/MS directly result from enzymaticdigestion of Tg originally in the test sample; thus, the level ofselected Tg peptides in the test sample at the start of LC-MS/MS isdirectly proportional to the amount of Tg originally present in the testsample.

Any suitable size separation technique may be utilized, but in theexamples that follow, both the first and second size separationtechniques are filtration through a molecular weight cut-off filter. Itis also possible, as discussed in the Examples that follow, to select amolecular weight cut-off filter with an appropriate molecular weightcut-off such that the same filter can be used for both the first sizeseparation and the second size separation.

LC, most preferably HPLC, is utilized, may be utilized either alone orin combination with other purification methods, to purify selected Tgpeptides. This purification is combined with MS/MS, thereby providing anassay system for quantifying selected Tg peptides in a test sample. Thequantity of the selected Tg peptides in the test sample is then used todetermine the quantity of Tg in the original test sample. The Tgquantitation methods provided herein have enhanced specificity and areless subject to methodological problems (such as Tg antibodyinterference).

Suitable test samples may include any test sample that may contain theanalyte of interest. In some preferred embodiments, a sample is abiological sample; that is, a sample obtained from any biologicalsource, such as an animal, a cell culture, an organ culture, and thelike. In certain preferred embodiments, samples are obtained from amammalian animal, such as a dog, cat, horse, etc. Particularly preferredmammalian animals are primates, most preferably humans. Particularlypreferred samples include blood, plasma, serum, urine, saliva, tears,cerebrospinal fluid, or other body fluid or tissue samples. Such samplesmay be obtained, for example, from a patient; that is, a living personpresenting oneself in a clinical setting for diagnosis, prognosis, ortreatment of a disease or condition. The test sample is preferablyobtained from a patient, for example, serum or plasma.

Sample Preparation for Mass Spectrometry

Samples may be processed or purified to obtain preparations that aresuitable for analysis by mass spectrometry. Such purification willusually include chromatography, such as liquid chromatography, and mayalso often involve an additional purification procedure that isperformed prior to chromatography. Various procedures may be used forthis purpose depending on the type of sample or the type ofchromatography. Examples include filtration, centrifugation,combinations thereof and the like. In certain preferred embodiments, Tgpresent in a test sample prior to enzymatic digestion.

Filtration is one preferred method of preparing a test sample,especially a biological test sample, such as serum or plasma, forchromatography. Such filtration is carried out by filtering a testsample through a molecular weight cut-off filter to separate specieswith molecular weights higher than the filter's cut-off (including Tg)from those with molecular weights lower than the filter's cut-off. Thetest sample remaining above the filter following complete (or nearcomplete) filtration is substantially free of potentially interferingspecies with molecular weights lower than the filter's cut-off.

The pH of the test sample may then be adjusted to any point required bya digestion agent. In certain preferred embodiments, the digestion agentis trypsin and pH can be adjusted with a solution of ammonium acetate tohave a pH suitable for this enzyme. In these preferred embodiments, thesample is then digested with trypsin to form Tg peptides (includingpeptide T129).

After trypsin digestion, the sample may be purified with a secondfiltration. This post-digestion filtration can be carried out similarlyto the pre-digestion filtration described above (with the exception thatthe filtrate is retained), in order to separate Tg fragments frompotentially interfering species with molecular weights higher than thefilter's cut-off that may also be present in the sample. The filtratefrom this post-digestion filtration can then be purified by liquidchromatography and subsequently subjected to mass spectrometry analysis.

Various methods have been described involving the use of HPLC for sampleclean-up prior to mass spectrometry analysis. See, e.g., Taylor et al.,Therapeutic Drug Monitoring 22:608-12 (2000) (manual precipitation ofblood samples, followed by manual C18 solid phase extraction, injectioninto an HPLC for chromatography on a C18 analytical column, and MS/MSanalysis); and Salm et al., Clin. Therapeutics 22 Supl. B:B71-B85 (2000)(manual precipitation of blood samples, followed by manual C18 solidphase extraction, injection into an HPLC for chromatography on a C18analytical column, and MS/MS analysis). One of skill in the art mayselect HPLC instruments and columns that are suitable for use in themethods. The chromatographic column typically includes a medium (i.e., apacking material) to facilitate separation of chemical moieties (i.e.,fractionation). The medium may include minute particles. The particlesinclude a bonded surface that interacts with the various chemicalmoieties to facilitate separation of the chemical moieties. One suitablebonded surface is a hydrophobic bonded surface such as an alkyl bondedsurface. Alkyl bonded surfaces may include C-4, C-8, or C-18 bondedalkyl groups, preferably C-8 bonded groups. The chromatographic columnincludes an inlet port for receiving a sample and an outlet port fordischarging an effluent that includes the fractionated sample.

In certain embodiments, an analyte may be purified by applying a sampleto a column under conditions where the analyte of interest is reversiblyretained by the column packing material, while one or more othermaterials are not retained. In these embodiments, a first mobile phasecondition can be employed where the analyte of interest is retained bythe column and a second mobile phase condition can subsequently beemployed to remove retained material from the column, once thenon-retained materials are washed through. Alternatively, an analyte maybe purified by applying a sample to a column under mobile phaseconditions where the analyte of interest elutes at a differential ratein comparison to one or more other materials. Such procedures may enrichthe amount of one or more analytes of interest relative to one or moreother components of the sample.

In one embodiment, the sample to be analyzed is applied to the column atthe inlet port, eluted with a solvent or solvent mixture, and dischargedat the outlet port. Different solvent modes may be selected for elutingthe analytes of interest. For example, liquid chromatography may beperformed using a gradient mode, an isocratic mode, or a polytypic (i.e.mixed) mode. In preferred embodiments, HPLC is performed on ananalytical HPLC system with a C8 solid phase using 0.2% formic acid inHPLC Grade Ultra Pure Water and 0.2% formic acid in 100% methanol as themobile phases.

Numerous column packings are available for chromatographic separation ofsamples and selection of an appropriate separation protocol is anempirical process that depends on the sample characteristics, analyte ofinterest, presence of interfering substances and their characteristics,etc. Commercially available HPLC columns include, but are not limitedto, polar, ion exchange (both cation and anion), hydrophobicinteraction, phenyl, C-2, C-8, C-18, and polar coating on porous polymercolumns.

In one embodiment, the HPLC column has a C8 solid phase with a medianparticle size of 5 μm (nominal) and a median particle pore size of 100Å. In a preferred embodiment the column dimensions are 1.0 mm ID×50 mmlength (Phenomenex Corp. Luna 5μ C8(2) 100 Å New Column 50×1.0 mm,Phenomenex Cat. No. 00B-4249-A0 or equivalent).

During chromatography, the separation of materials is effected byvariables such as choice of eluent (also known as a “mobile phase”),choice of gradient elution and the gradient conditions, temperature,etc.

Detection and Quantitation by Mass Spectrometry

In various embodiments, Tg peptides may be ionized by any method knownto the skilled artisan. Mass spectrometry is performed using a massspectrometer, which includes an ion source for ionizing the fractionatedsample and creating charged molecules for further analysis. Ionizationsources used in various MS techniques include, but are not limited to,electron ionization, chemical ionization, electrospray ionization (ESI),photon ionization, atmospheric pressure chemical ionization (APCI),photoionization, atmospheric pressure photoionization (APPI), fast atombombardment (FAB)/liquid secondary ionization (LSIMS), matrix assistedlaser desorption ionization (MALDI), field ionization, field desorption,thermospray/plasmaspray ionization, surface enhanced laser desorptionionization (SELDI), inductively coupled plasma (ICP) and particle beamionization. The skilled artisan will understand that the choice ofionization method may be determined based on the analyte to be measured,type of sample, the type of detector, the choice of positive versusnegative mode, etc.

In preferred embodiments, Tg peptides are ionized by electrosprayionization (ESI) creating Tg peptide precursor ions. In relatedpreferred embodiments, Tg peptide precursor ions are in a gaseous stateand the inert collision gas is argon.

After the sample has been ionized, the positively charged ions therebycreated may be analyzed to determine m/z. Suitable analyzers fordetermining m/z include quadrupole analyzers, ion trap analyzers, andtime-of-flight analyzers. The ions may be detected using one of severaldetection modes. For example, only selected ions may be detected using aselective ion monitoring mode (SIM), or alternatively, multiple ions maybe detected using a scanning mode, e.g., multiple reaction monitoring(MRM) or selected reaction monitoring (SRM). In preferred embodiments,ions are detected using SRM.

Preferably, m/z is determined using a quadrupole instrument. In a“quadrupole” or “quadrupole ion trap” instrument, ions in an oscillatingradio frequency field experience a force proportional to the DCpotential applied between electrodes, the amplitude of the RF signal,and m/z. The voltage and amplitude may be selected so that only ionshaving a particular m/z travel the length of the quadrupole, while allother ions are deflected. Thus, quadrupole instruments may act as both a“mass filter” and as a “mass detector” for the ions injected into theinstrument.

One may enhance the resolution of the MS technique by employing “tandemmass spectrometry,” or “MS/MS.” In this technique, a precursor ion (alsocalled a parent ion) generated from a molecule of interest can befiltered in an MS instrument, and the precursor ion subsequentlyfragmented to yield one or more fragment ions (also called daughter ionsor product ions) that are then analyzed in a second MS procedure. Bycareful selection of precursor ions, only ions produced by certainanalytes are passed to the fragmentation chamber, where collision withatoms of an inert gas produce the fragment ions. Because both theprecursor and fragment ions are produced in a reproducible fashion undera given set of ionization/fragmentation conditions, the MS/MS techniquemay provide an extremely powerful analytical tool. For example, thecombination of filtration/fragmentation may be used to eliminateinterfering substances, and may be particularly useful in complexsamples, such as biological samples.

Additionally, recent advances in technology, such as matrix-assistedlaser desorption ionization coupled with time-of-flight analyzers(“MALDI-TOF”) permit the analysis of analytes at femtomole levels invery short ion pulses. Mass spectrometers that combine time-of-flightanalyzers with tandem MS are also well known to the artisan.Additionally, multiple mass spectrometry steps may be combined inmethods known as “MS/MS”. Various other combinations may be employed,such as MS/MS/TOF, MALDI/MS/MS/TOF, or SELDI/MS/MS/TOF massspectrometry.

The mass spectrometer typically provides the user with an ion scan; thatis, the relative abundance of each ion with a particular m/z over agiven range (e.g., 400 to 1600 amu). The results of an analyte assay,that is, a mass spectrum, may be related to the amount of the analyte inthe original sample by numerous methods known in the art. For example,given that sampling and analysis parameters are carefully controlled,the relative abundance of a given ion may be compared to a table thatconverts that relative abundance to an absolute amount of the originalmolecule. Alternatively, molecular standards may be run with the samplesand a standard curve constructed based on ions generated from thosestandards. Using such a standard curve, the relative abundance of agiven ion may be converted into an absolute amount of the originalmolecule. In certain preferred embodiments, an internal standard is usedto generate a standard curve for calculating the quantity of Tg. Methodsof generating and using such standard curves are well known in the artand one of ordinary skill is capable of selecting an appropriateinternal standard. Numerous other methods for relating the amount of anion to the amount of the original molecule will be well known to thoseof ordinary skill in the art.

One or more steps of the methods may be performed using automatedmachines. In certain embodiments, one or more purification steps areperformed on-line, and more preferably all of the LC purification andmass spectrometry steps may be performed in an on-line fashion.

In certain embodiments, techniques such as MS/MS are used to isolateprecursor ions for further fragmentation. In these embodiments,collision activation dissociation (CAD) may be used to generate thefragment ions for further detection. In CAD, precursor ions gain energythrough collisions with an inert gas, and subsequently fragment by aprocess referred to as “unimolecular decomposition”. Sufficient energymust be deposited in the precursor ion so that certain bonds within theion can be broken due to increased vibrational energy. In alternativeembodiments, electron transfer dissociation (ETD) may be used togenerate the fragment ions. In ETD, radical anions are used to transferelectrons to multiply charged peptide or protein cations resulting inrandom cleavage along the peptide backbone.

In particularly preferred embodiments, Tg is detected and/or quantifiedusing LC-MS/MS as follows. A Tg peptide enriched test sample prepared asdescribed above is subjected to LC. The flow of liquid solvent from thechromatographic column enters the heated nebulizer interface of aLC-MS/MS analyzer and the solvent/analyte mixture is converted to vaporin the heated tubing of the interface. The analyte (e.g., Tg peptides),contained in the nebulized solvent, is ionized by the corona dischargeneedle of the interface, which applies a large voltage to the nebulizedsolvent/analyte mixture. The ions (i.e. Tg peptide precursor ions) passthrough the orifice of the instrument and enter the first quadrupole.Quadrupoles 1 and 3 (Q1 and Q3) are mass filters, allowing selection ofions (i.e., “precursor” and “fragment” ions) based on their m/z.Quadrupole 2 (Q2) is the collision cell, where ions are fragmented. Q1selects for ions with m/z of peptide T129 precursor ions (m/z of636.4±0.5). Selected precursor ions are allowed to pass into thecollision chamber (Q2), while ions with any other m/z collide with thesides of Q1 and are eliminated. Precursor ions entering Q2 may befragmented with collision activated dissociation (CAD) throughcollisions with neutral argon gas molecules. Alternatively, if theprecursor ions entering Q2 are multiply charged cations, they may befragmented with electron transfer dissociation (ETD). The fragment ionsgenerated are passed into Q3, where selected fragment ions are collectedwhile other ions are eliminated.

Using standard methods well known in the art, one of ordinary skill iscapable of identifying one or more fragment ions of a particular Tgpeptide precursor ion that may be used for selection in Q3. A specificfragment ion is one that will not be formed in significant amounts byother molecules with similar molecular structures. In contrast, anon-specific fragment ion is one that is formed by molecules other thanthe desired analyte. Suitable specific fragment ions can be identifiedby testing various molecular standards to determine whether fragmentions formed by a selected Tg peptide are also formed by other moleculeswith similar structures or features. Preferably, at least one fragmention specific for Tg peptide ions with m/z corresponding to that ofpeptide T129 ions are identified. More preferably, one or more of thesefragment ions have m/z of 797.4±0.5, 912.4±0.5 or 1059.5±0.5.

As ions collide with the detector they produce a pulse of electrons thatare converted to a digital signal. The acquired data is relayed to acomputer, which plots ion counts per unit time. The areas under thepeaks corresponding to particular ions, or the amplitude of such peaks,are measured and the area or amplitude is correlated to the amount ofthe analyte of interest. In certain embodiments, the area under thecurves, or amplitude of the peaks, for fragment ion(s) and/or precursorions are measured to determine the amount of Tg peptides with m/zcorresponding to peptide T129. As described above, the relativeabundance of a given ion may be converted into an absolute amount of theoriginal analyte using calibration standard curves based on peaks of oneor more ions of an internal molecular standard. The absolute amount ofan analyte detected by LC-MS/MS can then be converted into an absoluteamount of Tg that was present in the original test sample.

The following examples serve to illustrate the invention. These examplesare in no way intended to limit the scope of the methods.

EXAMPLES Example 1 Demonstration of MS Quantitation of Peptide T129

Several samples with various known concentrations of peptide T129 wereprepared by series dilution starting with a sample of known peptide T129concentration. Peptide T129 LOQ and calibration curves were developedfrom LC-MS/MS analysis of these samples.

LC was performed with a Phenomenex analytical column (Phenomenex Corp.Luna 5μ C8(2) 100 Å New Column 50×1.0 mm) A binary HPLC eluent composedof 0.2% formic acid in ultra pure water (HPLC grade) (mobile phase A)and 0.2% formic acid in 100% methanol (mobile phase B) was applied tothe analytical column to separate selected Tg peptides from otherspecies contained in the sample. The binary eluent was applied accordingto the following gradient profile: as a first step, an 80/20 mixture ofmobile phase A/mobile phase B was applied for 120 seconds; as a secondstep, a 30/70 mixture of mobile phase A/mobile phase B was applied for60 seconds; as a third step, the relative amount of mobile phase B inthe mixture was ramped to a 5/95 mixture of mobile phase A/mobile phaseB over a period of 120 seconds; as a fourth step, a 5/95 mixture ofmobile phase A/mobile phase B was applied for 60 seconds; as a fifth andfinal step, an 80/20 mixture of mobile phase A/mobile phase B wasapplied for 240 seconds.

The separated sample was then subjected to MS/MS for quantitation of oneor more Tg peptides with m/z corresponding to peptide T129.

MS/MS was performed using a Finnigan TSQ Quantum Ultra MS/MS system(Thermo Electron Corporation). The following software programs all fromThermoElectron were used in the Examples described herein: Tune Master V1.2 or newer, Xcalibur V 2.0 SR1 or newer, TSQ Quantum 1.4 or newer,LCQuan V 2.0 or newer, and XReport 1.0 or newer. Liquid solvent/analyteexiting the analytical HPLC column flowed to the heated nebulizerinterface of a Thermo Finnigan MS/MS analyzer. The solvent/analytemixture was converted to vapor in the heated tubing of the interface.Analytes in the nebulized solvent were ionized by the corona dischargeneedle of the interface, which applied voltage to the nebulizedsolvent/analyte mixture.

Ions passed to the first quadrupole (Q1), which selected ions with a m/zof 636.4±0.5. Ions entering Quadrupole 2 (Q2) collided with argon gas togenerate ion fragments, which were passed to quadrupole 3 (Q3) forfurther selection. Mass transitions used for quantitation of precursorions with m/z corresponding to peptide T129 during validation onpositive polarity are shown in Table 1.

TABLE 1 Mass transitionsfor precursor ions with m/z corresponding topeptide T129 (Positive Polarity) Precursor Ion (m/z) Fragment Ion (m/z)636.4 ± 0.5 797.4 ± 0.5, 912.4 ± 0.5 & 1059.5 ± 0.5

To determine the limit of quantitation (LOQ) with a precision of 20% andan accuracy of 80% to 120%, seven different samples at varyingconcentrations were assayed and the reproducibility (CV) determined foreach. The LOQ for one or more Tg peptides with m/z corresponding topeptide T129 was defined at about 67 amol/μl.

Data collected and used to develop the LOQ and Calibration curves inFIGS. 5 and 6 is shown in Table 2.

TABLE 2 Data collected and used to develop LOQ and Calibration curvesfor peptide T129 in spiked stripped serum samples Femtomoles PeptideT129 of peptide Average Ion Concentration T129 in 30 μl Counts per(Attomoles/μl) sample Second CV (%) 2.5 0.075 1471.6 0.264429 25 0.752435.6 0.188653 75 2.25 6455.4 0.147946 150 4.5 13322.4 0.075327 300 928805 0.073374 450 13.5 46199.6 0.067088 600 18 61302.2 0.030893

Example 2 Demonstration of Quantitation of Peptide T129 in Peptide T129Spiked Processed, Concentrated and Digested Stripped Serum

A 500 μl sample of stripped serum (e.g., the test sample in thisExample) was added atop the filter element of a commercially available300 kDa molecular weight cut-off filter cartridge (Pall Corp. Nanosep300 kDa, Pall Corp. Cat. No. OD300C33).

The test sample was completely filtered upon centrifugation of thecartridge at 13 kg for 6 minutes. The filtrate was removed anddiscarded. 500 μl of HPLC grade water was then added to the top of thefilter and the cartridge was again centrifuged at 13 kg for 6 minutes.The filtrate was again removed and discarded. Next, 200 μl of 20 mMammonium acetate was added to the top of the filter. The cartridge wasagain centrifuged at 13 kg for 3 minutes. The filtrate was again removedand discarded and 100 μl of 20 mM ammonium acetate was added to the topof the filter.

Then, 15 μg of trypsin (Promega Trypsin Gold, Mass Spec Grade, PromegaCorp. Cat. No. V5280 or equivalent) was added to the test sampleremaining on top of the filter. The resulting mixture was incubatedwithout removal from the filter cartridge at 37 C for up to 17 hours.

After incubation, the filter cartridge was centrifuged at 13 kg for 6minutes, and the filtrate retained. The filter cartridge was then washedby adding 50 μl of 20 mM ammonium acetate to the top of the filter andcentrifuged at 13 kg for 6 minutes. Test samples for analysis byLC-MS/MS were created by pooling the two retained post-digestionfiltrates.

The starting volume of stripped serum samples subjected to the aboveprocessing and concentration was about 500 μl. The final volume of eachpooled post-digestion filtrate was about 130 μl. Thus the above processconcentrates samples by a factor of 3.83.

Peptide T129 was then added to the pooled post-digestion filtrates invarying concentrations. 30 μl samples were then analyzed forquantitation of peptide T129 by LC-MS/MS according to the proceduredescribed in Example 1 with the exception that the mass transitionsshown in Table 3 were used. The fragment ion with a m/z of 797.4±0.5 wasnot used due to increased background generated by the processed,concentrated stripped serum.

TABLE 3 Mass transitions for precursor ions with m/z corresponding topeptide T129 from peptide T129 spiked stripped serum samples (PositivePolarity) Precursor Ion (m/z) Fragment Ion (m/z) 636.4 ± 0.5 912.4 ± 0.5& 1059.5 ± 0.5

Data collected and used to develop the LOQ and Calibration curves foundin FIGS. 7 and 8 is shown in Table 4.

TABLE 4 Data collected and used to develop LOQ and Calibration curvesfor peptide T129 Femtomoles of Average Ion Tg in spiked Counts per serumsample Second CV (%) 0.75 203 0.348839 1.5 957.25 0.263782 3 2984.750.269659 4.5 6504.75 0.063318 11.25 18210.5 0.097296 22.5 37620 0.08582330 51451 0.035083

Example 3 Demonstration of Quantitation of Peptide T129 in StrippedSerum Containing Various Concentrations of Added Tg

Several 500 μl samples of stripped serum containing variousconcentrations of added Tg were prepared according to the proceduredetailed in Example 2. LC-MS/MS of the resulting test samples wascarried out following the steps detailed in Example 1.

Data collected and used to develop the calibration curve found in FIG. 9are found in Table 6.

TABLE 6 Data collected and used to develop the calibration curve forpeptide T129 MS/MS in Tg spiked stripped serum (processed and condensedas described in Example 3). Femtomoles of Average Ion Tg in spikedCounts per serum sample Second CV (%) 0 8784.667 0.176987 1.5 8259.50.246833 4.5 9953.25 0.186588 11.25 9696.25 0.23816 22.5 13848.250.225496 45 18125.5 0.110826

The contents of the articles, patents, patent applications, and allother documents and electronically available information mentioned orcited herein, are hereby incorporated by reference in their entirety tothe same extent as if each individual publication was specifically andindividually indicated to be incorporated by reference. Applicantsreserve the right to physically incorporate into this application anyand all materials and information from any such articles, patents,patent applications, or other physical and electronic documents.

The methods illustratively described herein may suitably be practiced inthe absence of any element or elements, limitation or limitations, notspecifically disclosed herein. Thus, for example, the terms“comprising”, “including,” containing”, etc. shall be read expansivelyand without limitation. Additionally, the terms and expressions employedherein have been used as terms of description and not of limitation, andthere is no intention in the use of such terms and expressions ofexcluding any equivalents of the features shown and described orportions thereof, but it is recognized that various modifications arepossible within the scope of the invention claimed. Thus, it should beunderstood that although the present invention has been specificallydisclosed by preferred embodiments and optional features, modificationand variation of the invention embodied therein herein disclosed may beresorted to by those skilled in the art, and that such modifications andvariations are considered to be within the scope of this invention.

The invention has been described broadly and generically herein. Each ofthe narrower species and subgeneric groupings falling within the genericdisclosure also form part of the methods. This includes the genericdescription of the methods with a proviso or negative limitationremoving any subject matter from the genus, regardless of whether or notthe excised material is specifically recited herein.

Other embodiments are within the following claims. In addition, wherefeatures or aspects of the methods are described in terms of Markushgroups, those skilled in the art will recognize that the invention isalso thereby described in terms of any individual member or subgroup ofmembers of the Markush group.

That which is claimed is:
 1. A method for determining the amount ofthyroglobulin in a test sample, comprising: (a) enriching a digestedthyroglobulin (Tg) peptide comprising an amino acid sequenceVIFDANAPVAVR (SEQ ID NO: 4); (b) ionizing the Tg peptide to generate oneor more ions detectable by mass spectrometry; (c) quantifying the amountof the one or more Tg peptide ions from step (b) by mass spectrometry,wherein the amount of the one or more Tg peptide ions is related to theamount of thyroglobulin in said test sample.
 2. The method of claim 1,wherein the test sample comprises a body fluid.
 3. The method of claim2, wherein the body fluid comprises serum or plasma.
 4. The method ofclaim 1, wherein the test sample comprises a thyroglobulin autoantibody.5. The method of claim 1, wherein the test sample is taken from apatient suffering from thyroid cancer.
 6. The method of claim 1, furthercomprising a digestion step that is carried out in the presence oftrypsin.
 7. The method of claim 1, wherein the mass spectrometry istandem mass spectrometry.
 8. The method of claim 1, wherein the ionizingstep comprises ionizing the Tg peptide to generate a multiply chargedions detectable by mass spectrometry.
 9. The method of claim 1, furthercomprising purifying thyroglobulin from a body fluid or tissue sample togenerate a thyroglobulin containing test sample.
 10. The method of claim1, wherein the mass spectrometry is performed in positive ion mode. 11.The method of claim 1, wherein the mass spectrometry is quadrupole ortime-of-flight (TOF) mass spectrometry.
 12. The method of claim 11,wherein the TOF mass spectrometry is matrix-assisted laser desorptionionization coupled with TOF (MALDI-TOF).
 13. The method of claim 1,wherein the mass spectrometry comprises electrospray ionization.
 14. Themethod of claim 1, further comprising liquid chromatography.
 15. Themethod of claim 14, wherein the liquid chromatography is highperformance liquid chromatography (HPLC).
 16. The method of claim 1,further comprising using a C18 column.
 17. The method of claim 1,further comprising protein precipitation.
 18. A method of diagnosing ormonitoring thyroid cancer comprising the steps of claim 1.